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TO:  Maternity Care Providers


 


Effective
immediately, payment will be denied for all global maternity delivery and
postpartum codes filed as an emergency. Additionally, the Agency will recoup
previous reimbursement for these codes filed as an emergency.


 


Providers should not bill global delivery codes as emergency services.
An emergency maternity service is the delivery only (i.e., the emergency
management of an impending delivery). It does not include prenatal care,
postpartum care, or other maternity related services. During these types of
emergencies, it is appropriate to bill delivery only codes (vaginal or
cesarean) but not the global maternity or postpartum codes. Eligible CPT Codes for
deliveries, when provided as an emergency service, are limited to the
following:


 








CPT Procedure Code

Procedure Code Description

59409

Vaginal
delivery only

59514

Cesarean
delivery only

59612

Vaginal
delivery only, after previous cesarean

59620

Cesarean
delivery only, following attempted vaginal delivery after previous cesarean
delivery


 


For questions, please visit www.medicaid.alabama.gov
or call the Medicaid Fiscal Agent at


1-800-688-7989.


 

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